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[]
[null,"（スタートアップ創出促進保証制度用）",{"$nulls":45},"令和５年３月１５日制定"]
[]
[null,"創業計画書"]
[]
[{"$nulls":43},"令和\n西暦",{"$nulls":7},"年",null,null,null,"月",null,null,null,"日"]
[null,"岐阜県信用保証協会 御中"]
[]
[{"$nulls":43},"　（どちらかに○印を付けてください）"]
[{"$nulls":30},"〔申込人〕"]
[null,"　スタートアップ創出促進保証制度の申込みにあたり、以下のとおり創業計画書を提出いたします。",{"$nulls":29},"住所"]
[{"$nulls":31},"会社名"]
[{"$nulls":31},"氏名または代表者名"]
[]
[null,null,null,"【同意事項】"]
[null,null,null,"スタートアップ創出促進保証制度を利用するにあたり、貴協会が以下に掲げる当社※の情報を、以下に掲げ"]
[null,null,null,"る利用目的のために、経済産業省に対して提供することについて同意いたします。"]
[null,null,null,"また、原則として、創業者が会社を設立して３年目、５年目に、中小企業活性化協議会が実施するガバナン"]
[null,null,null,"ス体制の整備に関するチェックを受けることについて同意いたします。"]
[null,null,null,"※会社設立前の創業者が個人で申込む場合や、分社化を計画している親会社が申込む場合は、当該情報は情報提供の対象外のため"]
[{"$nulls":4},"情報提供いたしません。"]
[]
[null,null,null,"  １.提供する情報",{"$nulls":15},"中小企業者の商号、所在地、資本金、会社設立日、申込金融機関、\n保証申込金額、保証承諾日、保証承諾金額"]
[]
[null,null,null,"  ２.提供先における利用目的",{"$nulls":15},"政策効果の検証"]
[]
[]
[null,null,null,"【確認状況記載欄】"]
[null,null,null,"本計画書が申込人の意思に基づいて正しく記載されていること及び情報提供の同意について次の通り確認して"]
[null,null,null,"おります。"]
[null,null,null,"確認年月日",{"$nulls":8},"確認時間",{"$nulls":7},"確認方法（該当する番号にチェック）",{"$nulls":23},"金融機関本支店名・確認者"]
[null,null,null,"令和   年   月   日",{"$nulls":8},"　時　　分",{"$nulls":7},"  １電話　   ２来店面談　   ３訪問面談　   ４その他（　　　　　）　"]
[]
[null,"１．事業概要"]
[]
[null,null,null,"会 社 名 （予定含む）"]
[]
[null,null,null,"開業(予定)住所"]
[{"$nulls":13},"電話　   　（　    　）　    　　"]
[null,null,null,"設 立 登 記（法人）",{"$nulls":9},"有　　・　　無",{"$nulls":17},"設立(予定)年月日",{"$nulls":10},"令和\n西暦"]
[]
[null,null,null,"業  　　　種",{"$nulls":27},"資　本　金",{"$nulls":9},"〔会社設立予定を含む〕"]
[{"$nulls":57},"円"]
[null,null,null,"許　可　等",{"$nulls":9},"（種類）",{"$nulls":17},"（根拠法）"]
[null,null,null,"[許可等取得が必要な場合]",{"$nulls":14},"（許可・免許・登録・認証の別を記入）",{"$nulls":18},"[取得すべき許可等の根拠法を記入（（例）食品衛生法）]"]
[null,null,null,"従業員数",{"$nulls":16},"名",null,"取扱品",{"$nulls":12},"仕入先"]
[]
[null,null,null,"開業動機・目的"]
[]
[null,null,null,"開業に必要な知識、技術、ノウハウの習得"]
[]
[null,null,null,"〔会社設立予定を含む〕"]
[null,null,null,"出資者・出資額"]
[null,null,null,"事業協力者の住所・氏名・勤務先"]
[]
[]
[null,"２．創業準備の着手状況 （税務申告１期以上終了している者は記入省略可）　"]
[null,null,null,"下記の該当事項に○印を付けて下さい"]
[null,"　　ア　設備機械器具等発注済である。　　　　　　　　　　　　　　　　"]
[null,"　　イ　土地・店舗を取得するための頭金等支払済みである。"]
[null,"　　ウ　土地・店舗を賃借するための権利金・敷金支払済みである。"]
[null,"　　エ　商品・原材料の仕入を行っている。"]
[null,"　　オ　事業に必要な許認可を受けている。"]
[null,"　　カ　事業に必要な許認可取得未了（許認可取得見込み（申請状況や取得予定時期等）を具体的に記入してください。）"]
[null,"　　　（　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　）"]
[null,"　　キ　その他（具体的に記入して下さい　　　　　　　　　 　　　  　　　　　　　　）"]
[]
[null,"３．必要な資金及び調達の方法（税務申告１期以上終了している者は記入省略可）　　　　　　　　　　　　　　　　　　　　　　　"]
[null,null,null,"次の（１）又は（２）のいずれかにチェックのうえ、自己資金割合が満たしていることをご確認ください。"]
[null,null,null,"税務申告１期未終了の創業者のうち、会社設立済であり売上高の計上がある者は（１）又は（２）のどちらか"]
[null,null,null,"にチェックの上確認でも可。"]
[{"$nulls":5},"（１）税務申告１期未終了の創業者"]
[null,null,null,"必要な資金",{"$nulls":21},"金　額（千円未満切捨）",{"$nulls":7},"調達の方法",{"$nulls":17},"金　額（千円未満切捨）"]
[null,null,null,"設備資金",null,null,"不動産取得費、内装工事費、敷金、入居保証金、機械設備、什器備品など（内訳）",{"$nulls":24},"千円",null,"自己資金",null,null,"普通預金",{"$nulls":20},"千円"]
[{"$nulls":36},"定期性預金",{"$nulls":20},"千円"]
[{"$nulls":36},"有価証券等",{"$nulls":20},"千円"]
[{"$nulls":36},"入居保証金等",{"$nulls":20},"千円"]
[{"$nulls":36},"設備充当等",{"$nulls":20},"千円"]
[{"$nulls":36},"その他",{"$nulls":20},"千円"]
[{"$nulls":57},"千円"]
[{"$nulls":57},"千円"]
[{"$nulls":36},"小計（Ａ）",{"$nulls":14},"",{"$nulls":5},"千円"]
[{"$nulls":33},"借入金等",null,null,"親戚・知人等からの借入\n（内訳）"]
[{"$nulls":57},"千円"]
[null,null,null,"運転資金",null,null,"仕入資金、経費支払資金など\n（内訳）",{"$nulls":24},"千円",{"$nulls":25},"千円"]
[{"$nulls":57},"千円"]
[{"$nulls":36},"金融機関からの借入\n（内訳）"]
[{"$nulls":57},"千円"]
[{"$nulls":57},"千円"]
[{"$nulls":57},"千円"]
[{"$nulls":57},"千円"]
[{"$nulls":57},"千円"]
[{"$nulls":57},"千円"]
[{"$nulls":57},"千円"]
[{"$nulls":36},"小計（Ｂ）",{"$nulls":14},"",{"$nulls":5},"千円"]
[null,null,null,"合　計",{"$nulls":21},"",{"$nulls":5},"千円",null,"合　計（Ｃ）＝（Ａ）＋（Ｂ）",{"$nulls":17},"",{"$nulls":5},"千円"]
[null,null,null,"自己資金割合確認欄",{"$nulls":29},"（Ａ）／（Ｃ）",{"$nulls":17},""]
[null,null,null,"※創業時の資金計画で自己資金割合を算出し、（Ａ）／（Ｃ）≧１／１０（０．１）"]
[]
[{"$nulls":5},"（２）税務申告１期未終了の創業者のうち会社設立済であり売上高の計上がある者"]
[null,null,null,"自己資金割合確認欄",{"$nulls":29},"資本金（Ｄ）",{"$nulls":23},"千円"]
[{"$nulls":33},"借入金等（Ｅ）",{"$nulls":23},"千円"]
[{"$nulls":33},"（Ｄ）／（（Ｄ）＋（Ｅ））",{"$nulls":17},""]
[null,null,null,"※申込時の試算表等で自己資金割合を算出し、（Ｄ）／（（Ｄ）＋（Ｅ））≧１／１０（０．１）"]
[]
[null,"４．収支計画（今後１年間分）　　　　　　　　　　　　　　　　　　　　　　　"]
[null,null,null,"支　　　　　　　　　　　出",{"$nulls":27},"収　　　　　　　　　　　入"]
[null,null,null,"仕入高",{"$nulls":24},"千円",null,null,"売上高",{"$nulls":24},"千円"]
[null,null,null,"外注工費",{"$nulls":24},"千円",null,null,"工賃収入",{"$nulls":24},"千円"]
[null,null,null,"人件費",{"$nulls":24},"千円",null,null,"雑収入",{"$nulls":24},"千円"]
[{"$nulls":28},"千円",{"$nulls":27},"千円"]
[null,null,null,"その他費用",{"$nulls":24},"千円",{"$nulls":27},"千円"]
[null,null,null,"利益",{"$nulls":24},"千円",{"$nulls":27},"千円"]
[null,null,null,"計",{"$nulls":6},"",{"$nulls":17},"千円",null,null,"計",{"$nulls":6},"",{"$nulls":17},"千円"]
[]
[null,"５．販売・仕入先　　　　　　　　　　　　　　　　　　　　　　　　　　　　"]
[null,null,null,"主な販売先\n・受注先",{"$nulls":8},"販売・受注　　　　予定額",{"$nulls":8},"回収方法",{"$nulls":9},"主な仕入先\n・外注先",{"$nulls":8},"仕入\n・外注予定額",{"$nulls":8},"支払方法"]
[{"$nulls":12},"年　         千円",{"$nulls":27},"年         　千円"]
[{"$nulls":12},"年　　　　　千円",{"$nulls":27},"年　　　　　千円"]
[{"$nulls":12},"年　　　　　千円",{"$nulls":27},"年　　　　　千円"]
[]
[null,"６．借入金等状況（※）　　　　　　　　　　　　　　　　　　　　　　　　　　"]
[null,null,null,"借入先等",{"$nulls":11},"資金使途",{"$nulls":12},"借入残高",{"$nulls":12},"残　　存\n返済期間",{"$nulls":8},"年　間\n返済額"]
[{"$nulls":39},"千円",{"$nulls":7},"ヶ月",{"$nulls":9},"千円"]
[{"$nulls":39},"千円",{"$nulls":7},"ヶ月",{"$nulls":9},"千円"]
[{"$nulls":39},"千円",{"$nulls":7},"ヶ月",{"$nulls":9},"千円"]
[{"$nulls":39},"千円",{"$nulls":7},"ヶ月",{"$nulls":9},"千円"]
[{"$nulls":39},"千円",{"$nulls":7},"ヶ月",{"$nulls":9},"千円"]
[null,null,null,"(※)現在負担している非事業性を含む借入金等で、今回の資金調達計画によるもの以外をご記入ください"]
[{"$nulls":5},"(経営者本人が負担している保証債務も含みます）。"]
[]
[null,"７．その他（計画に関する補足説明がありましたらご記入してください）"]